The increasing role of monoamine oxidase type B inhibitors in Parkinson's disease therapy.
BACKGROUND
The role of monoamine oxidase type B inhibitors in the treatment of Parkinson's disease has expanded with the new monoamine oxidase B inhibitor rasagiline and a new formulation, selegiline oral disintegrating tablets. As primary therapy in early disease monoamine oxidase B inhibitors reduce motor disability and delay the need for levodopa. In more advanced disease requiring levodopa, adjunctive monoamine oxidase B inhibitors reduce 'off' time and may improve gait and freezing.


OBJECTIVE
Rasagiline and selegiline oral disintegrating tablets may reduce the safety risks associated with the amfetamine and methamfetamine metabolites of conventional oral selegiline while retaining or improving therapeutic efficacy.


METHODS
Articles were identified by searches of PubMed and searches on the Internet and reviewed. All articles and other referenced materials were retrieved using the keywords 'Parkinson's disease', 'treatment' and 'monoamine oxidase B inhibitor' and were published between 1960 and 2007, with older references selected for historical significance. Only papers published in English were reviewed.


CONCLUSIONS
Accumulating data support the use of monoamine oxidase B inhibitors as monotherapy for early and mild Parkinson's disease and as adjunctive therapy for more advanced Parkinson's disease with levodopa-associated motor fluctuations. The recently released monoamine oxidase B inhibitor rasagiline and a new formulation, selegiline oral disintegrating tablets, have potential advantages over conventional oral selegiline.
Elmer
Lawrence W
LW
Center for Neurological Disorders, Parkinson's Disease and Movement Disorders Program University of Toledo College of Medicine, Department of Neurology, 3120 Glendale Avenue, Toledo, OH 43614, USA. lawrence.elmer@utoledo.edu
Bertoni
John M
JM
D000818:Animals; D002986:Clinical Trials as Topic; D006801:Humans; D007189:Indans / Q000627:therapeutic use; D007980:Levodopa / Q000627:therapeutic use; D008995:Monoamine Oxidase / Q000378:metabolism*; D008996:Monoamine Oxidase Inhibitors / Q000145:classification / Q000627:therapeutic use*; D010300:Parkinson Disease / Q000188:drug therapy* / Q000201:enzymology*
D007189:Indans; D008996:Monoamine Oxidase Inhibitors; C031967:rasagiline; D007980:Levodopa; D008995:Monoamine Oxidase